title: Efficacy of SLO-Microperimetry and Humphrey for evaluating macular sensitivity changes in advanced glaucoma.
abstract: OBJECTIVE
  To compare the efficacy of scanning laser ophthalmoscope microperimetry (SLO-MP) and Humphrey visual fields in detecting macular sensitivity changes in advanced glaucoma.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  25 patients with advanced primary open angle glaucoma and 2 consecutive abnormal Humphrey 10-2 SITA Standard visual field tests.
  
  
  METHODS
  Thirty-six eyes of 25 patients with 2 consecutive abnormal Humphrey 10-2 SITA Standard (H10) visual fields were retested with a modified 10-2 SLO-MP within 3 months of the last reliable H10. A standardized grid was used to mark the macula. Primary outcome was change in mean macular sensitivity (dB; H10 and SLO-MP) in relation to mean macular retinal nerve fibre layer (RNFL) thickness (µm) by SLO- optical coherence tomography (SLO-OCT). Secondary outcome was comparison of reliability indices for both tests. Linear regression was used for analysis.
  
  
  RESULTS
  Mean macular sensitivity was significantly lower in SLO-MP (9.33 ± 3.37 dB) than H10 (18.83 ± 6.46 dB; p < 0.0001). Mean macular RNFL thickness correlated significantly with retinal sensitivity by both SLO-MP (r = 0.39, p < 0.02) and H10 (r = 0.37, p < 0.03). Fixation losses were better controlled in SLO-MP (0.38 ± 1.1) than H10 (4.28 ± 7.9; p = 0.008). False-positive responses were similar (SLO-MP: 2.25 ± 4.53, H10: 1.78 ± 3.33; p = 0.80). A statistically significant difference was noted in the false-negative responses (SLO-MP: 26.87 ± 25.24, H10: 5.33 ± 9.70; p < 0.0001).
  
  
  CONCLUSIONS
  Macular sensitivity determined by both H10 and SLO-MP correlates significantly with mean macular RNFL thickness measured by SLO-OCT. Precise localization of the macula in SLO-MP results in lower fixation losses. Detection of denser field defects by SLO-MP results in higher false-negative responses. A larger sample size is needed to further study the value of this diagnostic tool.
authors.affiliation: University of Ottawa and Ottawa Hospital Research Institute, Ottawa, Ont. Electronic address: skulkarni@ohri.ca.
authors.forename: Sadhana V
authors.initials: SV
authors.lastname: Kulkarni
authors.forename: Stuart G
authors.initials: SG
authors.lastname: Coupland
authors.forename: David M
authors.initials: DM
authors.lastname: Stitt
authors.forename: John
authors.initials: J
authors.lastname: Hamilton
authors.forename: Jonathan J
authors.initials: JJ
authors.lastname: Brownstein
authors.forename: Karim F
authors.initials: KF
authors.lastname: Damji
mesh_terms: D000368:Aged; D015331:Cohort Studies; D005189:False Positive Reactions; D005260:Female; D005403:Fixation, Ocular / Q000502:physiology; D005902:Glaucoma, Open-Angle / Q000175:diagnosis / Q000503:physiopathology*; D006801:Humans; D008297:Male; D019721:Ophthalmoscopes; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012160:Retina / Q000503:physiopathology*; D012607:Scotoma / Q000175:diagnosis / Q000503:physiopathology*; D012684:Sensory Thresholds; D058609:Visual Field Tests / Q000379:methods*; D014794:Visual Fields / Q000502:physiology*